Summary:
Hyponatremia is a common electrolyte disorder in hospitalized patients. Although there are a few case reports of hyponatremia following stem cell transplantation (SCT), no reports concerning the incidence are currently available. We describe the occurrence of hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) following SCT. In a single center analysis of 140 patients, hyponatremia and SIADH were observed in 40 and 11.4% of patients, respectively, following SCT. Risk factors for SIADH included young age, transplantation from an HLA-mismatched or unrelated donor, cord blood transplantation, and graft-versus-host disease prophylaxis with methyl prednisolone. Multivariate analysis revealed that transplantation from an HLA-mismatched donor and performance of SCT in a child below 4 years of age were risk factors for SIADH. For patients who underwent SCT from an HLA-mismatched or unrelated donor, those with SIADH showed a significantly higher overall survival rate (90.9 vs 40.2%) and event-free survival rate (77.8 vs 33.8%) compared to those without SIADH. Overall, our data show that hyponatremia and SIADH are relatively common complications following SCT, especially in children below 4 years of age and after SCT from an HLA-mismatched donor.
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References
Adrogue HJ, Madias NE . Hyponatremia: review article. N Engl J Med 2000; 342: 1581–1589.
Ishikawa SE, Schrier RW . Pathophysiological roles of arginine vasopressin and aquaporin-2 in impaired water excretion. Clin Endocrinol 2003; 58: 1–17.
Smith DM, McKenna K, Thompson CJ . Hyponatremia: a review. Clin Endocrinol 2000; 52: 667–678.
Abe T, Takaue Y, Okamoto Y et al. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) in children undergoing high-dose chemotherapy and autologous peripheral blood stem cell transplantation. Pediatr Hematol Oncol 1995; 12: 363–369.
Festuccia F, Polci R, Pugliese F et al. Syndrome of inappropriate ADH secretion: a late complication of hemopoietic stem cell allograft. G Ital Nefrol 2002; 19: 353–360.
Bartter FC, Schwarz WB . The syndrome of inappropriate secretion of antidiuretic hormone. Am J Med 1967; 42: 790–806.
Peter HB . The syndrome of inappropriate antidiureric hormone secretion. Int J Biochem Cell Biol 2003; 35: 1495–1499.
Coenraad MJ, Meinders AE, Vanderbroucke JP et al. Causes of hyponatremia in the departments of internal medicine and neurosurgery. Eur J Int Med 2003; 14: 302–309.
Adrogue HJ, Madias NE . Hyponatremia. N Engl J Med 2000; 342: 1581–1589.
Sorensen JB, Andersen MK, Hansen HH . Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in malignant disease. J Intern Med 1995; 238: 97–110.
Sica S, Cicconi S, Sora F et al. Inappropriate antidiuretic hormone secretion after high-dose thiotepa. Bone Marrow Transplant 1999; 24: 571–572.
Chubati A, Miura I, Hatano Y et al. Syndome of appropriate secretion of antidiuretic hormone in patients with lymphoma-associated hemophagocytic syndrome. Ann Hematol 1995; 70: 53–55.
Ciaudo M, Chauvenet L, Audouin J et al. Peripheral T-cell lymphoma with hemophagocytic histiocytosis localized to the bone marrow associated with inappropriate secretion of antidiuretic hormone. Leukemia Lymphoma 1995; 19: 511–514.
Eliakim R, Vertman E, Shinhar E . Syndrome of inappropriate secretion of antidiuretic hormone in Hodgkin's disease. Am J Med Sci 1986; 291: 126–127.
Kelton JG, Logue G . Inappropriate antidiuretic hormone complicating histiocytic lymphoma. Arch Intern Med 1979; 139: 307–308.
Reddy P, Ferrara JL . Immunobiology of acute graft-versus-host disease. Blood Rev 2003; 17: 187–194.
Castenskiold EC, Kelsey SM, Collins PW et al. Functional hyperactivity of monocytes after bone marrow transplantation: possible relevance for the development of post-transplant complications or relapse. Bone Marrow Transplant 1995; 15: 879–884.
Nagler A, Bishara A, Brautbar C, Barak V . Dysregulation of inflammatory cytokines in unrelated bone marrow transplantation. Cytokines Cell Mol Ther 1998; 4: 161–167.
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Kobayashi, R., Iguchi, A., Nakajima, M. et al. Hyponatremia and syndrome of inappropriate antidiuretic hormone secretion complicating stem cell transplantation. Bone Marrow Transplant 34, 975–979 (2004). https://doi.org/10.1038/sj.bmt.1704688
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DOI: https://doi.org/10.1038/sj.bmt.1704688
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